Provider Demographics
NPI:1497529283
Name:CANAVOSIO THERAPY LLC
Entity Type:Organization
Organization Name:CANAVOSIO THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CANAVOSIO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:908-370-9641
Mailing Address - Street 1:89 BEECHWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-2121
Mailing Address - Country:US
Mailing Address - Phone:908-370-9641
Mailing Address - Fax:
Practice Address - Street 1:400 MAIN ST
Practice Address - Street 2:
Practice Address - City:BEDMINSTER
Practice Address - State:NJ
Practice Address - Zip Code:07921-2604
Practice Address - Country:US
Practice Address - Phone:908-370-9641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker